People of all ages and professions, including office workers and professional athletes, frequently suffer from shoulder injuries. If these wounds are not treated, they may result in chronic issues that have an impact on day-to-day living and cause pain and discomfort. Knowing how to accurately assess and diagnose common shoulder injuries is crucial for shoulder physiotherapists. With the aid of this knowledge, you can create a focused treatment strategy for your patients that gets to the cause of the issue and hastens their recovery.
The key steps in assessing and diagnosing typical shoulder injuries in physiotherapy will be covered in this blog post.
Anatomy Of The Shoulder
Due to its complexity and extensive range of motion, the shoulder is prone to injury. Understanding the anatomy of the shoulder is crucial for understanding common shoulder injuries and how to diagnose them.
The humerus, scapula, and clavicle are the three bones that make up the shoulder joint. The glenoid, a small socket on the scapula, holds the head of the humerus. The rotator cuff, which surrounds the shoulder joint and aids in stabilising and movability, is a collection of muscles and tendons.
Four muscles—the supraspinatus, infraspinatus, teres minor, and subscapularis—compose the rotator cuff. Together, these muscles, which attach the scapula to the humerus, allow you to lift your arm and rotate your shoulder.
Physiotherapists can more effectively diagnose the cause of their patients’ pain or discomfort by having a thorough understanding of the anatomy of the shoulder.
Common Shoulder Injuries And Their Diagnosis
Diagnosing shoulder injuries typically involves a combination of physical examination, imaging techniques such as X-rays and MRI scans, and patient history, as will be discussed later on. It is important to accurately diagnose the injury to determine the most appropriate course of treatment.
Common shoulder injuries can be broadly categorised into acute and chronic injuries. Acute injuries are typically caused by a traumatic event such as a fall or a sports injury. Chronic injuries, on the other hand, develop over time due to overuse or repetitive strain on the shoulder.
Some of the most common shoulder injuries include:
- Shoulder instability: This occurs when the ligaments and muscles that hold the shoulder joint together are weak or damaged, causing the joint to become unstable.
- Rotator cuff tear: This occurs when one or more of the tendons in the rotator cuff are torn, leading to weakness and pain in the shoulder.
- Shoulder impingement: This occurs when the tendons and bursa in the shoulder are compressed or pinched, causing pain and inflammation.
- Frozen shoulder: This is a condition where the shoulder joint becomes stiff and painful, making it difficult to move.
- SLAP tear: This is a tear of the labrum, which is the cartilage that surrounds the socket of the shoulder joint.
Physical Examination Of The Shoulder
In physiotherapy, a physical examination is a crucial part of identifying and classifying shoulder injuries. The patient typically undergoes the examination while standing, sitting, or lying down with their upper body exposed to the examiner. The following are some crucial aspects of a shoulder examination:
- Inspection: The examiner should look for any visible signs of deformity, swelling, or muscle wasting. They should also observe the patient’s posture and any abnormal movements of the shoulder.
- Palpation: The examiner should feel the shoulder joint, tendons, muscles, and bones for any tenderness, swelling, or other abnormalities. Palpation can help identify specific areas of pain and discomfort.
- Range of motion: The examiner should assess the patient’s active and passive range of motion in the shoulder joint. This involves asking the patient to move their shoulder in various directions and also moving the patient’s shoulder while they relax.
- Strength testing: The examiner should test the strength of the shoulder muscles, both individually and in groups. This can help identify weakness or muscle imbalances that may contribute to shoulder injuries.
- Special tests: The examiner may perform special tests to assess specific structures in the shoulder joint, such as the rotator cuff tendons or the labrum. These tests are designed to reproduce the patient’s symptoms and can help confirm a diagnosis.
A thorough physical examination of the shoulder is crucial for identifying the cause of pain and dysfunction. Based on the findings of the examination, the physiotherapist can develop a treatment plan that is tailored to the patient’s specific needs.
Imaging Techniques For Shoulder Injuries
Imaging techniques are often used to diagnose shoulder injuries, especially when the physical examination and history are inconclusive or unclear. There are several imaging techniques used in physiotherapy to diagnose shoulder injuries, including X-rays, ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) scans.
X-rays are often the first imaging test that is done to evaluate a patient with a suspected shoulder injury. They can show fractures, dislocations, arthritis, and bone spurs. Ultrasound uses high-frequency sound waves to create images of the inside of the body. It is often used to assess soft tissues like tendons, ligaments, and muscles. It can also be used to evaluate for bursitis, rotator cuff tears, and other conditions that affect the shoulder.
MRI and CT scans are often used when more detailed information is needed to diagnose a shoulder injury. MRI uses a powerful magnetic field and radio waves to produce detailed images of the inside of the body, including bones, soft tissues, and organs. It can provide information about the extent of a tear, the size of a cyst, or the extent of inflammation. CT scans use X-rays to produce detailed images of the inside of the body. They can be used to evaluate for fractures, arthritis, and other conditions that affect the shoulder.
It is important to note that imaging tests should not be used as the sole method for diagnosing a shoulder injury. The physical examination and the patient’s history are also essential in making an accurate diagnosis. In some cases, imaging tests may not be necessary, especially if the injury is mild and can be treated with conservative measures such as rest, ice, and physiotherapy.
Final Thoughts
Assessing and diagnosing shoulder injuries is a complex process that requires a combination of knowledge, skill, and experience. Physiotherapists play a crucial role in this process, helping patients to achieve optimal outcomes through accurate diagnosis and effective treatment. By understanding the anatomy of the shoulder, performing a thorough physical examination, and using appropriate imaging techniques, physiotherapists can accurately diagnose common shoulder injuries and develop an effective treatment plan.
If you live in the Blackburn area and are in need of physiotherapy for a shoulder injury, consider reaching out to Melbourne Hand Therapy. Our experienced team of Blackburn physiotherapists can provide you with the personalised care you need to get back to doing the things you love. Contact us today to schedule an appointment.
If you are experiencing shoulder problems and would like to discuss rehabilitation options with one of our fully qualified therapists, please call us at Melbourne Hand Therapy today (03) 9899 8490 or leave an enquiry and we will get back to you as soon as possible.
